Journal article
Per-oral endoscopic myotomy for the treatment of suspected paraneoplastic achalasia
International journal of gastrointestinal intervention, Vol.14(4), pp.186-189
10/31/2025
DOI: 10.18528/ijgii250056
Abstract
Background: Pseudoachalasia due to paraneoplastic syndrome is a rare condition. Malnutrition in these patients is associated with severe morbidity and mortality. In this study, we evaluate the safety and efficacy of per-oral endoscopic myotomy (POEM) for the palliation of symptoms in paraneoplastic achalasia.
Methods: Retrospective multicenter cohort study of consecutive patients with paraneoplastic achalasia who underwent POEM between January 2022 to December 2024. Paraneoplastic achalasia was suspected based on manometric findings of achalasia, concurrent diagnosis of cancer, the absence of direct tumor involvement in the esophagus/gastroesophageal junction and supported by a positive paraneoplastic panel when available. Technical success was defined as completion of the POEM. Clinical success was defined as a post-POEM Eckardt score ≤ 3 at follow-up.
Results: A total of 9 patients (median age 69 years; 55.5% male) with paraneoplastic achalasia underwent POEM during the study period. Small cell lung cancer (n = 6) was the most common cancer, and a positive serum paraneoplastic panel was identified in 71.4% of patients. Mean baseline Eckardt score was 7.67 ± 1.22. Technical success was achieved in 100% of patients with no intra- and post-procedural adverse events reported. Clinical success was achieved in 100% of the patients at a median follow-up of 10 months. There was a significant decrease in the overall mean Eckardt score and in the subscales of weight loss, regurgitation and dysphagia after POEM.
Conclusion: Malignant pseudoachalasia should be excluded in all patients with esophageal symptoms. Paraneoplastic syndrome should be suspected among cancer patients without direct tumor involvement. POEM may be a safe and effective palliative treatment for symptomatic paraneoplastic achalasia.
Details
- Title: Subtitle
- Per-oral endoscopic myotomy for the treatment of suspected paraneoplastic achalasia
- Creators
- Abdullah Abbasi - AdventHealth OrlandoSalmaan Jawaid - Baylor College of MedicinePetros Benias - Rutgers, The State University of New JerseyMuhammad Khalid Hasan - AdventHealth OrlandoMai Khalaf - Baylor College of MedicinePeter Vassilev Draganov - University of FloridaDennis Yang - AdventHealth Orlando
- Resource Type
- Journal article
- Publication Details
- International journal of gastrointestinal intervention, Vol.14(4), pp.186-189
- DOI
- 10.18528/ijgii250056
- ISSN
- 2636-0004
- eISSN
- 2636-0012
- Publisher
- SOC GASTROINTESTINAL INTERVENTION
- Language
- English
- Electronic publication date
- 08/11/2025
- Date published
- 10/31/2025
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984946700802771
Metrics
29 Record Views